Category archive: Medicaid

As every long-term care facility doing business in Illinois can attest, Medicaid eligibility determinations and benefit awards have been slow, with HFS often falling months, if not years, behind. A group of SNFs and their residents are trying to change that. Several healthcare providers and their patients have filed suit against Felicia Norwood in her…

The Centers for Medicare & Medicaid Services has unveiled two new websites for consumers that include information comparing rehabilitation facilities and long-term care facilities. CMS says that these websites are optimized for mobile use. The sites are located at medicare.gov/inpatientrehabilitationfacilitycompare/ and medicare.gov/longtermcarehospitalcompare/ By Jonathan W. McCrary

Implementation Date: November 28, 2016¹ Section 483.15 replaces section 483.12 and requires the facility to establish an admissions policy. Section (a)(2) states facilities cannot request or require residents or potential residents to waive their rights to Medicare or Medicaid benefits or any rights conferred by applicable state, federal and local licensing or certification laws. Section(a)(2)(iii)…

Over the next few weeks, the Sandberg Phoenix Long-Term Care and Senior Housing Team will be rolling out its analysis of the new CMS Final Rule revising the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. We will address each revision and how it impacts both the care…

Following recent natural disasters, such as Hurricane Sandy or episodes of serious flooding; the Centers for Medicare and Medicaid Services (CMS) published a Final Rule to help Medicaid & Medicare providers and suppliers plan for natural and man-made disasters. The new regulations provide consistent emergency preparedness requirements with a goal of enhancing patient safety during…

Discarded pharmaceuticals and the high cost of drugs continue to receive attention in the news, as well as from the Centers for Medicare and Medicaid Services (CMS). In response to these concerns, CMS recently issued a mandate updating the use by hospitals of the JW modifier to document discarded drugs or biologicals in patient’s medical…

Demonstrating the government’s commitment to combat health care fraud and keeping providers accountable, the U.S. Attorney’s office of Southern District announced that Regent Management Services L.P., a long term provider, agreed to pay approximately $3.199 Million to settle allegations that it received kickbacks from ambulance companies for referrals of Regent’s Medicare and Medicaid patients needing…